Stromectol, with the active ingredient ivermectin, is a well-established antiparasitic medication used globally to treat a range of parasitic infections. It belongs to the class of avermectins and operates by binding to glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, leading to increased cell permeability and paralysis of the parasites, resulting in their death. Its broad-spectrum efficacy and generally favorable safety profile, when used as directed for approved indications, have made it a critical tool in public health initiatives, particularly against neglected tropical diseases. This medication is available in oral tablet form and requires a prescription, ensuring treatment is guided by a healthcare professional based on a confirmed diagnosis.

Features

• Active Ingredient: Ivermectin
• Formulation: Oral tablets, typically 3 mg
• Mechanism of Action: Binds to chloride channels, causing paralysis and death of parasites
• Prescription Status: Requires a medical prescription
• Manufacturing Standards: Produced under strict pharmaceutical quality controls
• Shelf Life: Typically 24-36 months from the date of manufacture when stored correctly

Benefits

• Effectively eliminates a broad spectrum of parasitic nematodes and arthropods
• Contributes to the reduction of transmission in communities for certain parasitic diseases
• Single-dose regimen for many indications enhances patient compliance
• Generally well-tolerated with a low incidence of severe adverse effects at standard doses
• Plays a significant role in global mass drug administration programs for disease control

Common use

Stromectol (ivermectin) is indicated for the treatment of specific parasitic infections. Its primary and most well-documented use is for the treatment of strongyloidiasis of the intestinal tract, caused by the nematode Strongyloides stercoralis. It is also highly effective against onchocerciasis (river blindness), caused by the filarial worm Onchocerca volvulus. In many countries, it is used as part of public health campaigns for these diseases. Furthermore, it is used for the treatment of scabies, particularly crusted scabies, often in combination with topical agents. Its use for other conditions, such as other helminthic infections or off-label purposes, must be strictly determined and supervised by a qualified healthcare provider based on individual patient assessment and regional guidelines.

Dosage and direction

Dosage is strictly based on body weight and the specific infection being treated. It is crucial that this is calculated by a healthcare professional.

• Strongyloidiasis: A single oral dose of 200 mcg per kilogram of body weight.
• Onchocerciasis: A single oral dose of 150 mcg per kilogram of body weight. Treatment may be repeated every 3 to 12 months until asymptomatic, as determined by a physician.
• Administration: Tablets should be taken orally with a full glass of water on an empty stomach (at least 1 hour before or 2 hours after a meal) to maximize bioavailability.
• General Guidance: The precise dosing schedule, including the need for repeat doses, must be determined by a physician. Do not crush or chew the tablets.

Precautions

• Medical Supervision: Use only under the direct supervision of a physician who has experience in the diagnosis and management of parasitic infections.
• Neurological Conditions: Use with caution in patients with a history of or predisposition to seizures or other neurological disorders.
• HIV Co-infection: Patients with strongyloidiasis and concurrent HIV infection or other immunosuppressive conditions are at risk for hyperinfection syndrome and disseminated disease; they require careful monitoring and often more aggressive management.
• Driving and Operating Machinery: Since ivermectin can cause dizziness, drowsiness, or vertigo, patients should be cautioned about engaging in potentially hazardous activities until they know how the medication affects them.
• Pregnancy and Lactation: The benefit of treatment during pregnancy must clearly outweigh potential risks. Ivermectin is excreted in breast milk; a decision should be made whether to discontinue nursing or discontinue the drug.

Contraindications

Stromectol is contraindicated in:

• Patients with a known hypersensitivity to ivermectin or any component of the formulation.
• Individuals with suspected or confirmed Loa loa (African eye worm) infection, due to the risk of serious encephalopathic reactions.

Possible side effect

While generally well-tolerated at standard doses, some side effects may occur. Most are mild and transient.

• Common (≥1%): Diarrhea, nausea, vomiting, dizziness, pruritus (itching), urticaria (hives), rash, drowsiness, vertigo, tremor.
• Less Common (<1%): Orthostatic hypotension, fever, headache, swollen/tender lymph nodes, joint pain, myalgia (muscle pain), edema.
• Rare but Serious: Severe skin reactions (e.g., Stevens-Johnson syndrome), hepatitis, neutropenia, seizures, encephalopathy (particularly in patients with high microfilarial loads, e.g., in onchocerciasis), worsening of asthma.

Drug interaction

Formal drug interaction studies are limited. However, interactions are possible.

• CNS Depressants: Additive effects with other drugs that cause CNS depression (e.g., benzodiazepines, barbiturates, opioids, alcohol) may enhance dizziness and drowsiness.
• Warfarin: Ivermectin may potentially potentiate the effects of warfarin, increasing the risk of bleeding. Close monitoring of INR is advised.
• P-glycoprotein Inhibitors: Drugs that inhibit P-glycoprotein (e.g., quinidine, verapamil, cyclosporine) may increase ivermectin plasma concentrations, potentially increasing the risk of adverse effects.
• It is essential to provide your doctor with a complete list of all medications you are taking, including prescription, over-the-counter, and herbal products.

Missed dose

Since Stromectol is often administered as a single dose, the concept of a “missed dose” typically applies only if a repeat dose is prescribed. If you are on a multi-dose regimen and miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one. Always follow the specific instructions provided by your physician.

Overdose

Symptoms of overdose are primarily an extension of its pharmacological effects and adverse reaction profile.

• Symptoms: May include severe dizziness, nausea, vomiting, diarrhea, pupillary dilation, sedation, tremors, seizures, respiratory depression, and urticaria.
• Management: There is no specific antidote for ivermectin overdose. Management is supportive and symptomatic. Gastric lavage and administration of activated charcoal may be considered if ingestion was recent. Maintain a patent airway and provide supportive measures for respiration and circulation. Immediately contact a poison control center or emergency room.

Storage

• Store at room temperature between 15°C and 30°C (59°F and 86°F).
• Protect from light and moisture.
• Keep in the original blister pack or container until use.
• Keep out of reach of children and pets.
• Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The uses described may not be approved in all countries. Always follow the guidance of your local healthcare authorities and the prescribing information provided with your medication.

Reviews

Clinical and patient perspectives highlight the drug’s role in managing parasitic diseases.

Clinical Perspective: “Ivermectin remains a cornerstone of therapy for conditions like strongyloidiasis and onchocerciasis. Its impact on global health, particularly through mass drug administration programs, has been profound. Its single-dose efficacy significantly improves compliance in community settings.” – Infectious Disease Specialist

Patient Experience (Strongyloidiasis): “After being diagnosed, I was prescribed a single dose of Stromectol. The symptoms I had been experiencing for months began to resolve within a week. I experienced some mild dizziness the day after taking it, but it passed quickly. Follow-up tests confirmed the infection was cleared.” – Anonymous Patient

Public Health Perspective: “The use of ivermectin in annual mass drug administration has drastically reduced the prevalence of onchocerciasis in endemic areas, moving us closer to the goal of elimination. It is a powerful example of a scalable public health intervention.” – Public Health Official